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Doctor Assisted Dying

Volume 302: debated on Wednesday 10 December 1997

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4.14 pm

I beg to move,

That leave be given to bring in a Bill to enable a person who is suffering distress as a result of his terminal illness or incurable physical condition to obtain assistance from a doctor to end his life; and for connected purposes.
It is a rare occasion when the House debates death. I have been here for almost 30 years, and I can remember only two or three previous occasions. At any time, there are 300,000 terminally ill people in this country and there are fewer than 7,000 hospice beds. To give some idea of the size of the problem, 300,000 is roughly the population of Nottingham or Newcastle. It is important that on United Nations Human Rights Day, we take some time to debate the matter.

Those 300,000 people cannot lobby Parliament and they cannot come to our advice bureaux. They will not have a vote in the next election and there is no pressure group. Death will happen to all of us, but we shall not be here to tell others what it is like. It is always left to us to surmise how best we can help the terminally ill, and I am glad that we shall try to do that today.

It is significant that my hon. Friend the Parliamentary Secretary, Lord Chancellor's Department made a statement about a Green Paper today, but nothing he said covered my Bill. He made it clear that the Government were against euthanasia. My Bill, however, is not—I repeat not—concerned with euthanasia. The international definition of euthanasia is mercy killing. Under my Bill, nobody will kill anybody. It is important to recognise that distinction. Under my Bill, nobody will take a person's life.

Why am I introducing the Bill at this time? The House will remember that on 28 October, less than six weeks ago, a very brave woman called Annie Lindsell came to the High Court. She was suffering from motor neurone disease and she said that her wish was to live until Christmas. In the event that she could not help herself and because she was terrified of choking to death when there was nobody with her, she asked for her doctor to be given permission from the High Court to administer drugs, even though they would shorten her life.

She was a very brave woman, as my hon. Friend says. She would have been sitting here today if, unfortunately, she had not died two weeks ago.

The Attorney-General was astonished by the case, and he sent his official solicitor to the High Court to say that he could not understand why a patient should have to go to the court to ask for the necessary treatment. The cost of the case, I might add, was £30,000. Annie Lindsell made history. She was a wonderful woman of 47 who had originally expected to live for only three years after contracting motor neurone disease, but who lived for five years. She was determined to try to change history. She may well have done so, because the statement by my hon. Friend the Parliamentary Secretary, Lord Chancellor's Department may have opened debate on the subject for the first time.

My other reason for introducing the Bill—I do not want to get personal about this, because every family has been through this sort of thing—is that I saw my mother dying over seven years. She had Parkinson's disease. In the last year of her life, she could hardly move. She could not turn over in bed, she could not talk or walk and she could barely eat. She was virtually living the life of a vegetable. I can remember her saying to me, "I'll be glad when my time comes." She said it not once, but quite a few times. My father nursed her as she withered away to four stone. He died first from a heart attack caused by the stress. She then stopped eating and followed him two months later. I decided then that I did not want to go in such circumstances. I have waited a long time to bring the Bill to the House. People should have the right at the end to say, "I want to depart. I've had enough."

The current situation is a doctor's dilemma. Drugs that alleviate pain, such as diamorphine in the case of Annie Lindsell, also shorten life. As the illness gets worse and creates more pain, more drugs have to be administered and the doses come closer to terminating life. Every doctor knows about that double effect.

There is a huge void in the law. When does it become legal to give more drugs to alleviate pain, even though that terminates life? Some doctors will assist patients who say that they want to die with dignity, but there is no law that says that they can. The patient has no legal right to choose and the doctor has no legal right to administer more drugs. Some doctors refuse for ethical or religious reasons. Some will give only enough drugs to alleviate pain, not enough to hasten death. One doctor in the north-east has admitted that he has shortened life, as have others elsewhere. He is being investigated by the Crown Prosecution Service. One of the reasons why Annie Lindsell went to court was so that her doctor would be covered.

The religious and ethical issues are very difficult. The British Medical Association decided, without balloting its members, that it did not want a change in the law for the time being. As it stands, the law can lead to unofficial euthanasia, but the patient has no choice—no chance of being given dignity to shorten their life by four or five weeks.

There is obviously a religious aspect to the issue. I have searched through the religious policies on the problem. The Catholic Church—this feeling was particularly strong across America—said:
"It is not euthanasia to give a dying person sedatives and analgesics for the alleviation of pain, even though the drugs may deprive the patient of reason or shorten his life."
A famous House of Lords Select Committee on Medical Ethics came out against euthanasia a couple of years ago. However, it said that it
"would have a generally permissive approach to the double effect of relieving pain and shortening life."
A social survey in 1996 showed that 82 per cent. of the population supported the measures in the Bill.

Obviously, there must be safeguards against abuse. Two doctors—a general practitioner and a specialist consultant on the illness—would have to sign a permission form. The patient would also have to be diagnosed terminally ill—that would not be available on request. The doctor could refuse, but would have to pass the patient on to another doctor. Every death under the system would be reported to the coroner's office for checking and investigation. A code of practice would be laid down by the Department of Health, to ensure that the issues were dealt with in an ethical manner. There would be a maximum penalty of 14 years' imprisonment for abusing the system.

The Bill has been tested by some of the leading legal and medical professionals in the country. It would give absolute safeguards to any patient. A patient could cancel their request at any time.

I understand the religious objections. There are bound to be people of deep faith who believe that life should take its course. I respect their faith, but they do not have the right to take away the freedom of someone who does not share that faith. There are many people of different faiths with different beliefs. We are talking about a voluntary act. The Bill would give the right to a voluntary, merciful shortening of life, giving dignity to an inevitable death. I hope that the House will show mercy and approve it.

4.24 pm

I trust that the House will not feel that there is a lack of compassion on any side of the argument about such a dreadful and painful subject. Many of us have had experiences similar to that of my hon. Friend the Member for Bassetlaw (Mr. Ashton), either directly in our own families or on the periphery of decisions to turn off life-sustaining machines. Therefore, no one should be seen as lacking compassion.

I find it strange that, having explained the present position in law, my hon. Friend suggested that legislation was required. Even in the case that he cited, the House of Lords has made the position quite clear. If a doctor administers medicine to alleviate pain and suffering and that results in the shortening of a person's life—although that does not necessarily happen—it is not euthanasia or murder. Much depends on the intent of the person administering the medicine.

If one considers the argument from a religious point of view, different people will have different attitudes. I understand that a practising Christian will not convince an agnostic or an atheist, but what is the role of the state? How do we govern ourselves and our society?

We have already outlawed capital punishment and said that it is wrong. It is now being proposed that the state should regulate a death industry in another way by passing such legislation. I immediately concede that the motive is entirely different, but we would be legislating on how people should die, and that is a dangerous thing to do. [Interruption.] Hon. Friends around me say that we have a right to die, but I am not sure whether I accept that argument, because rights normally assume duties. What is the duty incumbent on the right to die?

I accept that we shall all face death at one time or another, but have we the right to ask other people to help us die? Have people a duty to help others to die? If there is no such duty—and no one would argue that there is—has an individual the right to say, "Although I do not have a duty to do so, I volunteer to help you to die"? What is the position of a doctor—or anyone else such as an uncle, an aunt or a cousin—volunteering to help someone to die? That right would not relate to a person's status—it would be inherent.

It is significant that the British Medical Association and all the medical societies say that it would be quite wrong for a doctor to seek to assist a person to die. I believe that they have taken the right attitude. However, there are other arguments. Such debates usually mention the Dutch experiment, which is often portrayed as humane, interesting and special—something that could be adopted if we were properly liberal. Yet in 1990, when the Dutch Attorney-General had an inquiry, he found that of the 3,300 registered deaths by euthanasia, more than 1,000—nearly a third—had not been requested by the patient.

That is the real danger that we enter when people take upon themselves the right to decide for others whether they will live or die. There is a slippery slope and sadly, it concerns not only people who are terminally ill but people who are mentally and physically disabled, and even old people. It also concerns questions such as: who will benefit from auntie's will? Those are the real dangers in such legislation.

Finally, I think that my hon. Friend has missed the developments in palliative care that have taken place. Nowadays there is no need for anybody to die in agony. Developments in medical care have shown that to be the case. The proportion of 5 per cent. has been referred to. That 5 per cent., too, need not die in pain. The evidence is there.

When we listen to my hon. Friend's case, we must put aside our religious and other standpoints and ask ourselves whether we really want the state to decide who will live and who will die—a death industry to decide. Do we want to start on the slippery slope that makes the right to live dependent on the often selfish ideas and indulgences of other individuals? Do we really think it better for people to be put in a position in which they may be under pressure to want to die?

I do not think that we want that sort of society. It is a denial of our human dignity and our ability to face problems and overcome them rather than taking what some would regard as a coward's way out and saying, "Let's put an end to it all." Instead, let us look at ways of ending people's fear.

Question put, pursuant to Standing Order No. 23 (Motions for leave to bring in Bills and nomination of Select Committees at commencement of public business):—

The House divided: Ayes 89, Noes 234.

Division No. 111]

[4.32 pm


Allen, GrahamDavies, Rt Hon Ron (Caerphilly)
Austin, JohnDavis, Rt Hon David (Haltemprice)
Baker, NormanDismore, Andrew
Barnes, HarryDonohoe, Brian H
Barron, KevinDrown, Ms Julia
Bennett, Andrew FEnnis, Jeff
Berry, RogerEtherington, Bill
Blears, Ms HazelFitzpatrick, Jim
Blunt, CrispinGeorge, Andrew (St Ives)
Body, Sir RichardGeorge, Bruce (Walsall S)
Bradley, Peter (The Wrekin)Gibson, Dr Ian
Brown, Russell (Dumfries)Godsiff, Roger
Burden, Richard
Campbell, Menzies (NE Fife)Gorrie, Donald
Cann, JamieGriffiths, Jane (Reading E)
Clarke, Tony (Northampton S)Harris, Dr Evan
Clwyd, AnnHealey, John
Cohen, HarryHeppell, John
Colman, TonyHodge, Ms Margaret
Colvin, MichaelHope, Phil
Cooper, YvetteHopkins, Kelvin
Davey, Valerie (Bristol W)Illsley, Eric
Davidson, IanJenkins, Brian

Johnson, Miss Melanie (Welwyn Hatfield)Rendel, David
Russell, Bob (Colchester)
Jones, Ms Jenny (Wolverh'ton SW)Salter, Martin
Sanders, Adrian
Khabra, Piara SSawford, Phil
Kingham, Ms TessSedgemore, Brian
Livingstone, KenSheldon, Rt Hon Robert
Llwyd, ElfynShipley, Ms Debra
Lock, DavidSimpson, Alan (Nottingham S)
McAllion, JohnSoley, Clive
McCabe, SteveSteinberg, Gerry
McCafferty, Ms ChrisTemple-Morris, Peter
McDonnell, JohnTownend, John
McWalter, TonyTurner, Desmond (Kemptown)
Mallaber, JudyVis, Dr Rudi
Maxton, JohnWigley, Rt Hon Dafydd
Merron, GillianWinnick, David
Michie, Bill (Shef'ld Heeley)Winterton, Ms Rosie (Doncaster C)
Mullin, ChrisWise, Audrey
O'Neill, MartinWood, Mike
Öpik, LembitWoolas, Phil
Organ, Mrs Diana
Plaskitt, James

Tellers for the Ayes:

Powell, Sir Raymond

Mr. Joe Ashton and

Rammell, Bill

Dr. Jenny Tonge.


Adams, Mrs Irene (Paisley N)Clark, Paul (Gillingham)
Ainger, NickCollins, Tim
Ainsworth, Peter (E Surrey)Connarty, Michael
Amess, DavidCook, Frank (Stockton N)
Ancram, Rt Hon MichaelCorbyn, Jeremy
Anderson, Donald (Swansea E)Cormack, Sir Patrick
Arbuthnot, JamesCrausby, David
Ashdown, Rt Hon PaddyCunliffe, Lawrence
Atherton, Ms CandyCunningham, Ms Roseanna (Perth)
Atkinson, David (Bour'mth E)
Atkinson, Peter (Hexham)Dalyell, Tarn
Ballard, Mrs JackieDarvill, Keith
Battle, JohnDavies, Rt Hon Denzil (Llanelli)
Bayley, HughDavies, Quentin (Grantham)
Beard, NigelDawson, Hilton
Beggs, RoyDay, Stephen
Beith, Rt Hon A JDonaldson, Jeffrey
Bell, Stuart (Middlesbrough)Dorrell, Rt Hon Stephen
Benton, JoeDrew, David
Bercow, JohnDuncan, Alan
Bermingham, GeraldDuncan Smith, Iain
Best, HaroldEdwards, Huw
Blackman, LizEllman, Mrs Louise
Boateng, PaulEvans, Nigel
Boswell, TimFallon, Michael
Bottomley, Peter (Worthing W)Fearn, Ronnie
Brady, GrahamFlight, Howard
Brand, Dr PeterForsythe, Clifford
Brazier, JulianFoster, Michael Jabez (Hastings)
Brinton, Mrs HelenFox, Dr Liam
Browne, DesmondFyfe, Maria
Bruce, Ian (S Dorset)Galloway, George
Bruce, Malcolm (Gordon)Gapes, Mike
Burnett, JohnGarnier, Edward
Burns, SimonGill, Christopher
Burstow, PaulGoggins, Paul
Campbell, Alan (Tynemouth)Goodlad, Rt Hon Sir Alastair
Campbell, Ronnie (Blyth V)Gray, James
Campbell-Savours, DaleGreen, Damian
Canavan, DennisGrieve, Dominic
Casale, RogerHague, Rt Hon William
Cash, WilliamHall, Mike (Weaver Vale)
Chapman, Ben (Wirral S)Hall, Patrick (Bedford)
Chapman, Sir Sydney (Chipping Barnet)Hanson, David
Hayes, John
Chaytor, DavidHeald, Oliver
Church, Ms JudithHeath, David (Somerton & Frome)
Clark, Rt Hon Alan (Kensington)Heathcoat-Amory, Rt Hon David
Clark, Dr Michael (Rayleigh)Hepburn, Stephen

Hill, KeithPage, Richard
Hinchliffe, DavidPaice, James
Home Robertson, JohnPaisley, Rev Ian
Hood, JimmyPendry, Tom
Horam, JohnPickles, Eric
Howard, Rt Hon MichaelPike, Peter L
Howarth, Gerald (Aldershot)Pollard, Kerry
Hunter, AndrewPound, Stephen
Hutton, JohnPrior, David
Iddon, Dr BrianRandall, John
Ingram, AdamRapson, Syd
Jack, Rt Hon MichaelRobathan, Andrew
Jenkin, BernardRobertson, Laurence (Tewk'b'ry)
Johnson Smith, Rt Hon Sir GeoffreyRoe, Mrs Marion (Broxbourne)
Rogers, Allan
Jones, Barry (Alyn & Deeside)Rooney, Terry
Jones, Mrs Fiona (Newark)Ross, Ernie (Dundee W)
Jones, Helen (Warrington N)Rowlands, Ted
Jones, Ieuan Wyn (Ynys Môn)Roy, Frank
Jones, Nigel (Cheltenham)St Aubyn, Nick
Kaufman, Rt Hon GeraldSalmond, Alex
Keeble, Ms SallySayeed, Jonathan
Keetch, PaulShaw, Jonathan
Kelly, Ms RuthSheerman, Barry
Kennedy, Charles (Ross Skye)Shephard, Rt Hon Mrs Gillian
Key, RobertSimpson, Keith (Mid-Norfolk)
Kidney, DavidSkinner, Dennis
Kilfoyle, PeterSmith, Angela (Basildon)
King, Andy (Rugby & Kenilworth)Smith, Miss Geraldine (Morecambe & Lunesdale)
Ladyman, Dr Stephen
Lait, Mrs JacquiSmith, Sir Robert (W Ab'd'ns)
Lawrence, Ms JackieSoames, Nicholas
Letwin, OliverSpellar, John
Lewis, Ivan (Bury S)Spelman, Mrs Caroline
Lewis, Dr Julian (New Forest E)Spring, Richard
Lewis, Terry (Worsley)Stewart, David (Inverness E)
Liddell, Mrs HelenStinchcombe, Paul
Lidington, DavidStreeter, Gary
Lilley, Rt Hon PeterStunell, Andrew
Livsey, RichardSutcliffe, Gerry
Loughton, TimSwayne, Desmond
Luff, PeterSwinney, John
McAvoy, ThomasSyms, Robert
McCartney, Robert (N Down)Tapsell, Sir Peter
McDonagh, SiobhainTaylor, Ms Dari (Stockton S)
McFall, JohnTaylor, John M (Solihull)
McGuire, Mrs AnneTaylor, Sir Teddy
Mclntosh, Miss AnneThompson, William
McKenna, Mrs RosemaryTimms, Stephen
Maclean, Rt Hon DavidTipping, Paddy
Maclennan, Rt Hon RobertTouhig, Don
McLoughlin, PatrickTrend, Michael
McNamara, KevinTwigg, Derek (Halton)
McNulty, TonyTyler, Paul
MacShane, DenisVaz, Keith
Madel, Sir DavidViggers, Peter
Mahon, Mrs AliceWallace, James
Marshall, David (Shettleston)Walter, Robert
Marshall, Jim (Leicester S)Wareing, Robert N
Martlew, EricWaterson, Nigel
Maude, Rt Hon FrancisWatts, David
Mawhinney, Rt Hon Sir BrianWebb, Steve
Wells, Bowen
Meale, Alan
Michie, Mrs Ray (Argyll & Bute)Welsh, Andrew
Miller, AndrewWhittingdale, John
Moffatt, LauraWinterton, Mrs Ann (Congleton)
Moran, Ms MargaretWinterton, Nicholas (Macclesfield)
Murphy, Jim (Eastwood)Woodward, Shaun
Nicholls, Patrick
O'Brien, Bill (Normanton)

Tellers for the Noes:

O'Hara, Eddie

Miss Ann Widdecombe and

Olner, Bill

Mr. Jim Dobbin.

Question accordingly negatived.